NPIMap

Organization Active NPI

Preventive Medicine Associates

  • Addiction Medicine (Family Medicine) Physician
  • Brookline, MA
National Provider Identifier
1962451591
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
PREVENTIVE MEDICINE ASSOCIATES
Practice address
11 Kent St
Brookline, MA 02445-7901
Phone
(617) 383-6405
NPI assigned
May 10, 2006
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Punyamurtula Kishore, M.D.
Title
Director
Phone
(617) 383-6567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

11 Kent St
Brookline, MA 02445-7901

Mailing address

11 Kent St
Brookline, MA 02445-7901
Phone (617) 383-6405

National Provider Directory

National Provider Directory

Locations

11 Henshaw St
Brighton, MA 02135
Phone (617) 254-8500

Practitioners & affiliated clinicians

Practitioners 86

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 86

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1962451591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 KENT ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457901",
            "telephone_number": "617-383-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 KENT ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457901",
            "telephone_number": "617-383-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "KISHORE",
        "authorized_official_first_name": "PUNYAMURTULA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-383-6567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.